Visit-to-visit blood pressure variability and renal outcomes: results from ONTARGET and TRANSCEND trials

Journal of Hypertension
Giuseppe ManciaSalim Yusuf

Abstract

There is conflicting evidence on whether in treated hypertensive patients the risk of renal outcomes is associated with visit-to-visit SBP variability. Furthermore, limited evidence is available on how important is SBP variability for prediction of renal outcomes compared with on-treatment mean SBP. We addressed these issues in 28 790 participants of the Ongoing Treatment Alone and in combination with Ramipril Global End point Trial and Telmisartan Randomized Assessment Study in ace iNtolerant Subjects with Cardiovascular Disease trials. SBP variability was expressed as the coefficient of variation of the mean with which it showed no relationship. SBP variability and mean values were obtained from five visits during the first 2 years of treatment after the end of the titration phase. Incidence of several renal outcomes (end-stage renal disease, doubling of serum creatinine, new microalbuminuria, new macroalbuminuria and their composite) was calculated from the third year of treatment onward. Patients were divided in quintiles of SBP-coefficient of variation (SBP-CV) or mean SBP, which exhibited superimposable mean blood pressure and SBP-CV values, respectively. A progressive increase of SBP-CV was not accompanied by a parallel ...Continue Reading

References

Apr 2, 2008·The New England Journal of Medicine·UNKNOWN ONTARGET InvestigatorsCraig Anderson
Mar 17, 2010·The New England Journal of Medicine·William C CushmanFaramarz Ismail-Beigi
Dec 16, 2010·Journal of Hypertension·Giovanni CorraoGiuseppe Mancia
Mar 11, 2011·The New England Journal of Medicine·Hermann HallerUNKNOWN ROADMAP Trial Investigators
Dec 16, 2011·The American Journal of Cardiology·Stevo JuliusNevres Koylan
Sep 11, 2012·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Biagio Di IorioAntonio Bellasi
Sep 28, 2012·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Kei YokotaKazuomi Kario
Nov 6, 2012·The New England Journal of Medicine·Hans-Henrik ParvingUNKNOWN ALTITUDE Investigators
Jun 27, 2013·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Jicheng LvVlado Perkovic
Aug 3, 2013·European Heart Journal·Rajiv ChowdhuryOscar H Franco
Oct 18, 2013·Journal of Human Hypertension·G ParatiJ E Ochoa
Feb 1, 2014·Journal of Hypertension·Enayet K ChowdhuryUNKNOWN Second Australian National Blood Pressure Study Management Committee
Aug 12, 2014·Journal of the American College of Cardiology·John J SimSteven J Jacobsen
Sep 24, 2016·Journal of the American College of Cardiology·Elvira O GosmanovaCsaba P Kovesdy

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